The evolving field of mobile health (mHealth) is revolutionizing collection, management, and quality of clinical data in health systems. Particularly in low- and middle-income countries (LMICs), mHealth approaches for clinical decision support and record-keeping offer numerous potential advantages over paper records and in-person training and supervision. We conducted a content analysis of qualitative in-depth interviews using the Technology Acceptance Model 3 (TAM-3) to explore perspectives of providers and health managers in Madhya Pradesh and Rajasthan, India who were using the ASMAN (Alliance for Saving Mothers and Newborns) platform, a package of mHealth technologies to support management during the peripartum period. Respondents uniformly found ASMAN easy to use and felt it improved quality of care, reduced referral rates, ensured timely referral when needed, and aided reporting requirements. The TAM-3 model captured many determinants of reported respondent use behavior, including shifting workflow and job performance. However, some barriers to ASMAN digital platform use were structural and reported more often in facilities where ASMAN use was less consistent; these affect long-term impact, sustainability, and scalability of ASMAN and similar mHealth interventions. The transitioning of the program to the government, ensuring availability of dedicated funds, human resource support, and training and integration with government health information systems will ensure the sustainability of ASMAN.
Background Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – is a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of electronic case sheets), the role of CDSS in improving adherence to key clinical practices and delivery outcomes. Methods We have conducted secondary analysis of program data (government data) collected from 81 public facilities across four districts each in two sates of Madhya Pradesh and Rajasthan. The data collected between August –October 2017 (baseline) and the data collected between December 2019 – March 2020 (latest) was analysed. The data sources included: digitized labour room registers, case sheets, referral and discharge summary forms, observation checklist and complication format. Descriptive, univariate and multivariate and interrupted time series regression analyses were conducted. Results The completeness of electronic case sheets was low at postpartum period (40.5%), and in facilities with more than 300 deliveries a month (20.9%). In multivariate logistic regression analysis, the introduction of technology yielded significant improvement in adherence to key clinical practices. We have observed reduction in fresh still births rates and asphyxia, but these results were not statistically significant in interrupted time series analysis. However, our analysis showed that identification of maternal complications has increased over the period of program implementation and at the same time referral outs decreased. Conclusions Our study indicates CDSS has a potential to improve quality of intrapartum care and delivery outcome. Future studies with rigorous study design is required to understand the impact of technology in improving quality of maternity care.
A bstract Background With the Wuhan pandemic spread to India, more than lakhs of population were affected with COVID-19 with varying severities. Physiotherapists participated as frontline workers to contribute to management of patients in COVID-19 in reducing morbidity of these patients and aiding them to road to recovery. With infrastructure and patient characteristics different from the West and lack of adequate evidence to existing practices, there was a need to formulate a national consensus. Materials and methods Recommendations were formulated with a systematic literature search and feedback of physiotherapist experiences. Expert consensus was obtained using a modified Delphi method. Results The intraclass coefficient of agreement between the experts was 0.994, significant at p < 0.001. Conclusion This document offers physiotherapy evidence-based consensus and recommendation to planning physiotherapy workforce, assessment, chest physiotherapy, early mobilization, preparation for discharge planning, and safety for patients and therapist in acutec are COVID 19 setup of India. The recommendations have been integrated in the algorithm and are intended to use by all physiotherapists and other stakeholders in management of patients with COVID-19 in acute care settings. How to cite this article Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, et al. Evidence-based National Consensus: Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020;24(10):905–913.
Aim: To assess comparison of PEFR between Android and Gynoid Pattern Obesity in Females. Objectives: To assess Peak Expiratory Flow Rate in Android Pattern, Gynoid Pattern of Obesity in Females and compare Peak Expiratory Flow Rate between Android and Gynoid Pattern Obesity in Females. Methodology: 100 Female Obese Subjects with BMI> 30 in the Age Group between 20-40 yrs living a sedentary lifestyle were recruited with incidental sampling over the period of 1 year duration and allocated to Android (n = 50) and Gynoid (n = 50) groups on the basis of Adiposity Markers like BMI, Height, Weight, Waist Circumference (WC), Hip Circumference (HC), WHR - Waist Hip Ratio (WHR) and Waist to Height Ratio (WtHR). PEFR was recorded by taking 3 readings and the highest among them chosen. Results: Pearson correlation test and Linear Regression was done between PEFR & BMI, PEFR & WHR and PEFR & WHtR. Using an Unrelated t Test, results were found to be Significant (p < 0.05) between PEFR in Both the Groups. Conclusion: The study establishes that there is a difference in PEFR between Android and Gynoid Pattern of Obesity in Females and PEFR in Gynoid Pattern is 5% better than PEFR in the Android Pattern Obesity in Females. Key words: Obesity, Android, Gynoid, PEFR, BMI, WHR, WtHR, WC, HC.
Respiratory physiotherapeutic techniques have gained wide acceptance in reducing the pulmonary symptoms and improving the quality of life of Bronchiectasis patients. This study aims to compare the efficacy of ELTGOL technique (L' Expiration Lente Totale Glotte Ouverte en decubitus Lateral) which is a lesser known but increasingly popular airway clearance technique, versus ACBT (Active cycle of breathing techniques) which is the standard airway clearance technique, in improving the pulmonary impairments, exercise capacity and quality of life in middle aged bronchiectasis patients. 40 bronchiectasis patients were assessed and were divided into two groups-Group A and Group B. Each group had a total of 20 patients. Patients in Group A underwent ELTGOL therapy and Group B received ACBT as the airway clearance technique. The Breathlessness cough and sputum scale score, 6-minute walk distance and St. George Respiratory questionnaire score were assessed before and after 4 weeks of the said interventions. All the data analysis was done using SPSS software version 26. The study concluded that individually, ELTGOL and ACBT had a statistically significant role in improving the pulmonary impairments, exercise capacity and quality of life in middle aged bronchiectasis patient. However, there was insignificant difference between ELTGOL and ACBT in terms of improving the pulmonary impairments, functional capacity and health related quality of life in middle aged Bronchiectasis patients.
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